OBJECTIVE

To evaluate the effectiveness of standard and original methods of wound drainage after cardiac interventions.

MATERIAL AND METHODS

This study enrolled 180 patients divided into 2 groups. Mean age of patients was 58 [55; 65] and 59 [54; 64] years, respectively. In the first group, drainage tubes were inserted using original method. In the second group, drainage tubes were placed in standard fashion (two separate tubes in pericardial cavity and retrosternal space, other 1—2 additional tubes into pleural cavities if necessary). All patients underwent on-pump coronary artery bypass grafting and heart valve surgery. In postoperative period, active fluid drainage was performed using traditional chest drainage device «OP-01» under 20 cm H₂O.

RESULTS

No significant between-group differences in preoperative and intraoperative risk factors were found with the exception of ventilation time in the second group and chronic lung diseases in the first group. Time of postoperative drainage, blood loss, thoracentesis volume and incidence of postoperative pneumonia were similar. In the 2^nd group, pericardial effusion occurred in 16 (17.8%) patients. Insignificant volume (10—30 ml) was observed in 8 patients. In other 8 (8.9%) patients, pericardial drainage was needed for effusion >250—300 ml. Pericardiocentesis was associated with an additional risk of damage to the right ventricle. In the 1^st group, no pericardial effusion was determined by fluid drainage into the left pleural cavity through fenestration.

CONCLUSION

The proposed drainage technique ensures prevention of cardiac tamponade without additional manipulations and reduces the number of drain tubes.